Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00054
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2012
Parcel: 2S102AA05500
Jurisdiction: Tigard
Site address: 12215 SW MAIN ST
Project: Tigard Fitness Subdivision: KINGSTON Lot: 19
Project Description: Add new door and facade changes.
Contractor: JORDAN RICH CONSTRUCTION & REMODELING LL( Owner: CHOI, WOO Y & MAN JA
2936 NE 77TH AVE 2323 NE 165TH DR
PORTLAND, OR 97213 PORTLAND, OR 97230
PHONE: 971- 344 -3806 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 03/29/2012 $347.48
Class of Work: ALT Demolition
Dwelling Units: 0 Plan Review 03/21/2012 $225.86
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 03/21/2012 $138.99
Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM TI - Ping 03/29/2012 $64.00
Value: $17,627 DC Provision Review, COM TI - LRP 03/29/2012 $9.00
12% State Surcharge - Building 03/29/2012 $41.70
Info Process /Archiving - Sm $0.50 (up to 03/29/2012 $2.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $829.03
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -1 through c • R 952-0! 190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I �
Issued By: 1 , � Permittee Signature:
App-
Call 503.639.4175 by 7:00 a.m. for the next available Inspe date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application 2, •
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard R ,,,7 �� Permit No.: kuLpiio0 ///
° 13125 SW Hall Blvd., Tigard,OR 97223 MAR 2 1 2012 pan Rev ° li /
• Phone: 503.718.2439 Fax: 503.598.1960 Date/B : t � ERE a er Permit:
Tic - ;AK!) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By:' , G � luris: la See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notifie • • ethod: — f � - ✓/ Supplemental Information
;57111117 .0.069.1 09
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value ( rotded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. CATEGORY OF CONSTRUCTION work indicated on this application.
El m
1- and 2- family dwelling [Comercial /industrial Valuation: $
El Accessory building Multi- family Number of bedrooms: ,
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 2 Zib 514/ di4a 114 51 New dwelling area: square feet
City/State /ZIP: I ' c-r4 , 0 i 72 5// Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: /11(0 b Covered porch area square feet
Cross street/directions to job site: 1 . L me ( Deck area: square feet
I Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. J
r1� Valuation: $ j1/117 •
/L ` Existing building area square feet
id
. r
.00 ay. / 4 . 4, / ifvf ' /� New building area: square feet
PliI PROPERTY OWNER ❑ TENANT Number of stories:
Name: WO J ° �h C 0 I Type of construction:
Address: Z Z v e j - i fe Occupancy groups:
City /State /ZIP: o „ i- if;
, q 7z, 0 Existing:
Phone: (509 7 (_ 7 Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
.."--7 f (Please refer to fee schedule)
Business name: o- ,-, e......‘ Q 0 yt.g "4 e,. Q.✓• Structural plan review fee (or deposit):
Contact name: pi, (/fir/ vl 7: c€ review fee
Address: l FLS plan a ee (tf /
Total fees due upon application: At tt ,
City /State /ZIP:
Phone: ( ?eft' - g0 6 I Fax: : ( ) Amount received:
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
ro -top mounted PhotoVoltaic Solar Panel System.
Business name: o i , G••t„ � r , , Submt sets of roof plan with connectio ils
' � and fire departm cess, along with th - t Oregon
Address: _ • • /6 � c� C , Solar Installation Speer ode c • '4 1St.
City /State /ZIP: fW- 6.-.,__9, / ' ri 1771 3 Permit fee (includes • -view $180.00
Phone: ( pc( ,.- 3 l l F ax: ( ) and ad .. ' istrative fee ,:
(12% / State surs - :e (12 of permit fee): ` $21.60
CCB lie.: 1 i 6p 5 1 3 otal fee due upon application: .201.60
Authorized signature: V ir This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: / * Fee methodology set by Tri -County Building Industry
���� -. Service Board.
I:\Building\Permits\BUP -COM PernitApp.doc 02/24/2011 440- 4613T(I I /02 /COM/WEB)
I a . .
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Evcry project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
-
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
, (f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and .
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
•
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
III
e ° Building Division
Development Code Provision Review
r i c n R Commercial Projects with Approved Land Use
Building Permit No.: e o� D I 2, -0oo5' /
Land Use Casefile No.: 7i Q o 12- -oce -lot
Routed Plans:
Submittal Date: g off/ / a'
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked (1) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact 3 Fgy,( at 503-718-)S1/ 19 or J o h,/ ft @tigard - or.gov)
Ci Land Use Approval ,/
❑ Building Plans Match Approved Plan: Yes E No ❑
❑ Maximum Building Height
❑ Conditions Met
Notes: Addy DAR 0 /1 -Odrat
Original Plan: Approved Er Not Approved ❑ Date: 3 —d- /— /.2.
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Revie co ct Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
Actual Slope:
❑ PFI Permit #
❑ Conditi..' et
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
' Page 1 of 2
City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard - or.gov)
❑ Street Trees
❑ Protected Trees
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
•
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Ap�plic nt
Oka y to Issue Permit: Yes No ❑
Date Routed to Building:
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